DJUMA, Democratic Republic of the Congo, 7 December 2010 – The first day of Djuma’s mosquito net distribution provided the most festive few hours of two-year-old Nicole Katshinga’s life. It was as if the whole world had come to the remote village in Bandundu Province.

Officials in suits came across the Kwilu river, all the way from Bandundu town. Older boys climbed the trees to get a good view of their friends performing sketches about malaria. But the party was over all too quickly for little Nicole.

Amid the ambitious campaign, which distributed 85,000 impregnated nets over four days in Bandundu health zone several weeks ago, Nicole collapsed with convulsions.

Second bout of malariaThe little girl was treated at Djuma Referral Hospital. The hospital's director, Hugues Kapaya, said Nicole – who was experiencing the second bout of malaria in her short life – would be fine, though she'd have to stay in hospital for two or three days.

“At certain times of the year, 30 per cent of the beds are occupied by malaria cases," explained Dr. Kapaya.

"Whether or not patients come to the hospital depends more on their ability to pay us than on how much malaria there is in the area," he added. "People typically have two episodes of malaria a year but that can rise to three or four and a medical bill approaching €50, which is too much for the people here. Often we give away our work and our medicines.”

Nets save livesUNICEF Health Specialist Jean-Bosco Hulute noted that the insecticide-treated bed nets distributed at the end of October were made in Thailand.

"Funding from the European Union, World Bank, Global Fund and others has presented us with the opportunity to carry out the biggest distribution of impregnated malaria nets the DRC has ever seen," he said. “But the road infrastructure remains weak in the DRC. We have to lease vehicles. They break down. When nets reach distribution points, we have to rely on smaller vehicles, motorbikes or boats and canoes.

"Finally and most importantly," added Mr. Hulute, "the success of the campaign depends on thoroughly informing people so that they use the nets properly."

At Djuma Hospital in Bandundu Province, DR Congo, a baby is treated for malaria.

Education is keyAn important component of malaria sensitization campaigns is input from national leadership, ranging from government ministers to traditional chiefs.

“International studies have shown that if 80 per cent of households use mosquito nets, you register a 50 per cent drop in cases of malaria and an 18 per cent decrease in deaths," said Bandundu Province's medical co-ordinator for the fight against malaria, Dr Aimé Yiyi Mantempa. "In the context of the DRC, where malaria is endemic virtually everywhere, that is a huge impact."

Dr. Kapaya, however, takes a different view. “Much more must be done to improve sanitation. People must clear the dark corners of their homes and the greenery outside, where mosquitoes congregate. After all, nets are only effective when you are under them.”